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Introduction - new member
#1
Introduction - new member
Greetings to All

After a recent Ambulatory Sleep Test (suggested by my wife, who noticed my periods of 'suspended breathing' in the night) I embarked on my CPAP journey about a week ago. Currently still trying to settle on the best mask for me, having tried med and lrg pillows, and now a med nasal mask. All have had high leak rates, and my AHIs have been all over the map, varying between 1 and 15. Because of the high variability, I don't know if posting any particular Sleepyhead chart here would be useful, but tell me differently if you think better.

Sleep test summary: 'Severe' obstructive sleep apnoea, 45.6 abnormalities per hour, mainly hypops. Frequent mild O2 desats. Average O2 desats were 'mildly abnormal' at 4%. 18 mins spent below 90% sat.

Total sleep AHI 12.9, (OA 1.7, HI, 10.1, MA 1.2 CA 0). Supine AHI 17.5, RERA 32.7. Longest apnoea 34 secs.

Weirdly the results from my machine show the majority of my apnoeas are CA, whereas none were recorded during the sleep test!

My trial CPAP machine (ResMed Airsense 10) provider is a local pharmacy (Australia). I don't have a lot of faith in the depth of their knowledge. They don't yet know that (thanks to this forum) I know how to access the deeper menu settings and display detailed data. Rolleyes Their menthod so far has been to set the machine to auto. I haven't done any serious fiddling with the settings apart from tweaking humidity. Suggestions welcome on how to begin arriving at settings eg pressure that would work well for me.

Thanks... Jon
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#2
RE: Introduction - new member
Hi nathanoj,
WELCOME! to the forum.!
Hang in there for answers to your questions, good luck to you with CPAP therapy.
trish6hundred
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#3
RE: Introduction - new member
Welcome. I actually think some charts could be helpful Jon. What we can see from your profile and post is that you are using an Airsense 10 Autoset with a wide-open pressure range of 4-20. It would help to know what the EPR (exhale pressure relief) setting is, and the charts would show us correlations between pressure and events as well as a lot of other useful information including snores and flow limitations if any.

You will need 4-posts to link or attach a chart, or you can just link to an Imgur chart using a space in the address like h ttp://****. We can remove the space and see the chart. The first two links in my signature describe the preferred organization for Sleepyhead charts and how to link them from Imgur.

It is not uncommon for someone to have higher CA events in the beginning of therapy. They can be from a variety of issues like sleep disturbance, movement and of course they can also be real. A big problem with your settings is the wide-open range. This can be disruptive and interfere with sleep and is known to cause higher CA. EPR has an effect as well. It matters what your average and 95% pressure is, and the reasons why pressure increases is only evident from looking at the charts.

Good luck and look forward to helping in the near future.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#4
RE: Introduction - new member
EPR currently=1 I'll get some charts up soon.

Thanks for the welcome y'all.
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#5
RE: Introduction - new member
A range of results; 2 using nasal pillows followed by 2 using nasal mask

h ttp://imgur.com/5bj6qmx
h ttp://imgur.com/sSX7thB
h ttp://imgur.com/LFYsEU7
h ttp://imgur.com/9QVEaUr
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#6
RE: Introduction - new member
[Image: 5bj6qmx.jpg][Image: sSX7thB.jpg][Image: LFYsEU7.jpg][Image: 9QVEaUr.jpg]
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#7
RE: Introduction - new member
Those big long, flat-topped leaks are from your mouth, and a major issue in sleep disturbance. My impression on these graphs is that there is no consistency to the issues or events. I'd almost rather see you on a narrow range of pressure where you seem to get the best results, and that is between 7.0 and 10.0 cm. Your EPR is set to ramp-only, so it is not affecting your therapy during hte night. It's may not be a problem to switch to full-time, but I would leave it at 1. If you switch EPR to full time and your event rate increases, then that tells us something about variable pressure.

It's too early to make any conclusions regarding the CA It appears you are removing the mask in the morning where the events or something is disrupting your sleep. The event rate definitely increases as the night goes on and pressure increases, which is why I'd like to cap maximum pressure at 10.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#8
RE: Introduction - new member
Thanks for the insight on mouth leaks. Is a chin-strap indicated or (gasp) a full-face mask?

Last night's shenanigans ...

h ttp://imgur.com/c2I71eN

I switched to a small nasal mask because I measured my snout-width using the handy card supplied, and it said 'small'. The pharmacist had not even performed that step and had previously issued me with a medium. That said, switching to small hasn't done a lot to improve matters. The seal does feel good in an awake 'test' situation.

Last night I also upped my minimum pressure to 8 as I had been experiencing air-starvation at times. If I wish to set a pressure range, must the machine be set to APAP? (ie, is CPAP for a single fixed pressure only?).

I do experience some effort on exhalation and had only begun to get my head around how EPAP works (and how it has been implicated in causing increased events) while reading the board here yesterday. I noted (as you also mention) that, as EPAP was set to ramp, and the ramp was turned off, that the EPAP was doing nothing. I 'll test-drive a full-time EPAP of 1.
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#9
RE: Introduction - new member
The leaks are not coming from the mask to skin interface, but from when your mouth opens and just releases the pressure. Trust me, I hear this from my wife regularly. It's okay if it does not disturb your sleep or go into full-out large leaks, but it's better if you can avoid this. A surprisingly comfortable solution is a soft cervical collar that has a loose fit, but puts gentle pressure on the back of the jaw and keeps your mouth shut. They are very inexpensive. Trick is to get a fit that lets you fit a couple fingers between your neck and the collar, and something that puts very gentle upward pressure on the jaw. Most have found this better than a chin-strap. Since you seem to have long periods with these leaks, it might be helpful in avoiding the need to go with a full face mask.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#10
RE: Introduction - new member
Thanks Mate. But I don't have a cervix! Too-funny 

(Googles 'cervical collar') Ohhhhhh...! A neck brace! I'm with you now. Smile
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